Affecting approximately 4.4% of adults in the U.S., bipolar disorder is a mental health condition that involves manic (or hypomanic) and depressive episodes. While everyone experiences ups and downs, bipolar disorder causes more dramatic shifts in a person’s mood, thoughts, and energy, all of which can affect their ability to handle everyday tasks.
A common treatment recommendation is medication as it has been shown to help ease symptoms, allowing people to live functional lives. Here’s everything you need to know about medication for bipolar disorder, including the different types, symptoms, and choosing the best one for your unique situation.
Before being prescribed medication, you’ll need to get a thorough evaluation and diagnosis from a licensed healthcare provider as this will influence the proper course of treatment. There are three main types of bipolar disorder, although it can be thought of as a spectrum with other specified and unspecified bipolar disorders:
Knowing the type of bipolar disorder and the severity of your symptoms is important to ensure you are treated adequately.
If you have bipolar disorder or know someone who’s struggling, you may have wondered if the condition is curable. The short answer? No, bipolar disorder cannot be cured. Symptoms may come and go; however, people usually need lifelong treatment in order to function in their day-to-day lives and have an improved quality of life.
Several types of medications have been approved for treating the symptoms of bipolar disorder, including lithium, mood stabilizers, and antipsychotics. Oftentimes, treatment will involve a combination of medications that are custom to your specific symptoms, type of bipolar disorder, and individual needs.
Lithium is one of the oldest and most well-established treatments for bipolar disorder. It’s effective for treating acute mania, preventing future mood episodes, and reducing suicide risk. In fact, lithium has been shown it can reduce the risk of suicide attempts by 60-80%.
A drawback of lithium is that you need to have proper levels of it in your system, requiring you to get regular blood tests. If your levels are off, you risk lithium toxicity, which is defined by the following symptoms:
In cases of lithium toxicity, seek emergency medical care right away.
Originally created to treat seizures, certain anticonvulsants work well as mood stabilizers for bipolar disorder; however, they differ in the types of symptoms they treat:
Other anticonvulsants may be used off-label for concurrent symptoms such as pain, anxiety, weight loss, or sleep problems. These include pregabalin (Lyrica), gabapentin (Neurontin), and topiramate (Topamax).
Antipsychotics can be categorized into three generations: First-generation antipsychotics (FGAs), second-generation antipsychotics (SGAs), and third-generation antipsychotics )TGAs). Here’s a breakdown of each type:
FGAs | SGAs | TGAs | |
Medications | phenothiazines and haloperidol | clozapine, risperidone, olanzapine, and quetiapine | aripiprazole, brexpiprazole, lurasidone, cariprazine, and lumateperone |
Treatment | Acute mania, psychotic depression (when combined with antidepressants) | Mania, mixed features, depression | Mania, mixed features, depression |
Using antidepressants to treat bipolar disorder can be controversial. Current guidelines generally don’t recommend antidepressants as first-line treatment for bipolar depression, especially for those with Bipolar I disorder. This is due to the risk of antidepressants potentially triggering manic episodes or inducing rapid cycling.
Antidepressants may sometimes be prescribed alongside mood stabilizers in those with Bipolar II disorder, which tends to have more depressive episodes with less risk of medication-induced mania.
Common antidepressants that might be considered include:
Over one in four individuals with bipolar disorder in the United States are prescribed a benzodiazepine. Medications like lorazepam (Ativan) or clonazepam (Klonopin) may be prescribed on a short-term basis to manage anxiety, agitation, or insomnia during mood episodes. These medications are typically used cautiously due to the potential for dependency as substance use disorders are common amongst those with bipolar disorder.
There isn’t a one-size-fits-all medication regimen for bipolar disorder. Finding the right treatment for you will involve an evaluation by a psychiatrist who’s experienced in treating bipolar disorder. Your doctor will create a personalized treatment plan considering your specific symptoms, bipolar subtype, medical history, and personal preferences. This process requires patience and persistence as it may take time to find the right medication or combination that works best for you.
For some individuals with more severe presentations of bipolar disorder, multiple medications may be required. Research suggests that up to 20% of patients with bipolar disorder are prescribed four or more medications, which can result in different drug interactions or adverse side effects. It’s important to work closely with your doctor to ensure your treatment is safe and effective.
Most medications can have side effects, including those used to treat bipolar disorder. While every medication will have a different side effect profile, some of the most common ones include symptoms like:
When your doctor prescribes you medication, they will weigh the potential benefits against possible side effects. However, if you find certain side effects intolerable, discuss alternatives with your provider rather than stopping medication on your own, which can lead to withdrawal symptoms or symptom recurrence.
At Cura Behavioral Health, we understand that managing bipolar disorder requires individualized care and ongoing support, which is why we offer several treatment options, including medication management and evidence-based therapies. If you’re struggling with bipolar disorder, help is available. With the right treatment plan in place, many people with this condition lead stable and fulfilling lives.
Contact us today to learn more about how we can help you or a loved one take control of bipolar disorder and improve quality of life.
Bipolar Disorder – National Institute of Mental Health
Bipolar Disorder – National Institute of Mental Health
Lithium: current state of the art and future directions – International Journal of Bipolar Disorders
Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder – Medicina
Application of Antipsychotic Drugs in Mood Disorders – Brain Sciences
Antidepressants and Bipolar Disorder: The Plot Thickens – The American Journal of Psychiatry
Drug-Drug Interactions in Patients with Bipolar Disorder – Psychiatric Times
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
